A surgical instrument system for positioning a guide pin about a glenoid cavity that includes an anterior retractor. The anterior retractor includes a tip structured to engage a scapula, a lateral retractor shaft extending from the tip, and a medial retractor shaft extending substantially transverse from the lateral retractor shaft. The system further includes an alignment guide attachable to the anterior retractor, the alignment guide including an alignment guide shaft, a guide about a distal end of the alignment guide shaft, and a fastener for connecting the alignment guide shaft to the anterior retractor such that a longitudinal axis of the alignment guide shaft is aligned with a longitudinal axis of the medial retractor shaft when fastened thereto.
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1. A surgical instrument system for positioning a guide pin about a glenoid cavity comprising:
an anterior retractor that includes:
a tip structured to engage a scapula,
a lateral retractor shaft extending from the tip, and
a medial retractor shaft extending substantially transverse from the lateral retractor shaft; and
an alignment guide attachable to the anterior retractor, the alignment guide including:
an alignment guide shaft,
a guide about a distal end of the alignment guide shaft, and
a fastener for connecting the alignment guide shaft to the anterior retractor such that a longitudinal axis of the alignment guide shaft is aligned with a longitudinal axis of the medial retractor shaft when fastened thereto.
2. The surgical instrument system of
3. The surgical instrument system of
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8. The surgical instrument system of
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14. The surgical instrument system of
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19. The surgical instrument system of
20. The surgical instrument system of
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This application claims the benefit of U.S. Provisional Application No. 62/974,106 filed Nov. 14, 2019, entitled “Retractor Based Alignment Guides for Shoulder Arthroplasty Surgery” the entire disclosure of which is incorporated by reference herein in its entirety for all purposes.
The exemplary embodiments of the subject disclosure relate generally to a surgical instrument system for positioning a guide pin about a glenoid cavity.
Surgical retractors are used to obtain and maintain access to the anatomy being operated on during a surgical procedure. For most surgeries, several layers of tissue must be dissected through and moved aside (retracted) in order to access the anatomy to perform the operative procedure. It may be necessary to retract soft tissues, such as skin, muscle, fat, and internal organs or bony tissue, or both. While dissecting to reach the surgical site, the surgeon must also avoid damaging certain tissues, such as neural or vascular structures. A retractor system should allow the surgical team to access the surgical site by pushing the tissues aside and holding them in place while doing as little damage as possible to those tissues and also protecting particularly sensitive tissues such as nerves or vascular structures.
Space is an issue when performing an operation, such as a reverse shoulder arthroplasty. Access to the surgical site is limited by soft tissue, bone and also neural and vascular structures that must be protected and avoided. Retractors must be placed and held to access the surgical site, and often an alignment guide must then be placed to perform, for example, initial guide pin placement. In some cases the retractors interfere with other instruments. It is also necessary to control the retractor and the alignment guides separately, sometimes requiring two or more people to hold the retractor(s) and control the instrument being used. There thus remains a need for improved systems for providing retraction while manipulating anatomical parts during operative procedures.
In accordance with an exemplary embodiment, the subject disclosure provides a surgical instrument system for positioning a guide pin about a glenoid cavity that includes an anterior retractor, and an alignment guide attachable to the anterior retractor. The anterior retractor includes a tip structured to engage a scapula, a lateral retractor shaft extending from the tip, and a medial retractor shaft extending substantially transverse from the lateral retractor shaft. The alignment guide is attachable to the anterior retractor, and includes an alignment guide shaft, a guide about a distal end of the alignment guide shaft, and a fastener for connecting the alignment guide shaft to the anterior retractor such that a longitudinal axis of the alignment guide shaft is aligned with a longitudinal axis of the medial retractor shaft when fastened thereto.
In exemplary embodiments of the subject disclosure, the medial retractor shaft extends from the lateral retractor shaft at an angle of about 90 to about 110 degrees (e.g., 100 degrees). The tip can include a superior flare or curvature. In other exemplary embodiments, the medial retractor shaft extends a length at least twice a length of the lateral retractor shaft.
In alternative embodiments, the medial retractor shaft includes a manual indicia of position along the lateral retractor shaft. The medial retractor shaft can include at least one through hole for engaging the fastener. In an exemplary embodiment, the alignment guide is attachable to medial retractor adjacent a junction of the lateral retractor shaft and the medial retractor shaft.
In exemplary embodiments of the subject disclosure, the lateral retractor shaft includes a marking about an outer periphery a pre-determined distance from the tip corresponding to the distance from an anterior neck of a glenoid to an outer periphery of the glenoid cavity. In other exemplary embodiments, the anterior retractor further comprises a second lateral retractor shaft extending from the medial retractor shaft.
In accordance with another exemplary embodiment, the fastener is a cam lock. According to yet another embodiment, the alignment guide shaft includes at least one through hole with a longitudinal axis therethrough that extends at an angle from about 90 degrees to about 110 degrees from a longitudinal axis of the alignment guide shaft.
In accordance with yet another exemplary embodiment, the guide includes a guide aperture about the distal end of the alignment guide shaft. For example, the guide aperture can extend at an angle of from about 1 degrees to about 20 degrees from a longitudinal axis. A biased detent can also be provided about the guide aperture.
In accordance with yet another exemplary embodiment, the surgical instrument system further includes a guide pin cannula receivable by the guide. The guide pin cannula can include a distal tip that includes a flange, and the flange can extend at an angle of from about from about 5 to about 25 degrees from a plane perpendicular to a guide pin cannula shaft. The guide pin cannula includes a guide pin advanceable therein. Alternatively, the surgical instrument can include a guide insert including an inner aperture sized to receive a guide pin.
The following detailed description of the exemplary embodiments of the subject disclosure will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the present disclosure, there is shown in the drawings exemplary embodiments. It should be understood, however, that the subject application is not limited to the precise arrangements and instrumentalities shown.
Reference will now be made in detail to the exemplary embodiments of the subject disclosure illustrated in the accompanying drawings. Wherever possible, the same or like reference numbers will be used throughout the drawings to refer to the same or like features. It should be noted that the drawings are in simplified form and are not drawn to precise scale. In reference to the disclosure herein, for purposes of convenience and clarity only, directional terms such as upper, lower, top, bottom, above, below and diagonal, are used with respect to the accompanying drawings. Such directional terms used in conjunction with the following description of the drawings should not be construed to limit the scope of the subject disclosure in any manner not explicitly set forth. Additionally, the term “a,” as used in the specification, means “at least one.” The terminology includes the words above specifically mentioned, derivatives thereof, and words of similar import.
“About” as used herein when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of ±20%, ±10%, ±5%, ±1%, or ±0.1% from the specified value, as such variations are appropriate.
“Substantially” as used herein shall mean considerable in extent, largely but not wholly that which is specified, or an appropriate variation therefrom as is acceptable within the field of art.
As used herein, the term “adjacent” refers to being near or adjoining. Adjacent components (which can be integral or separate) can be spaced apart from one another, or can be in actual or direct contact with one another (i.e., directly adjacent).
Throughout the subject application, various aspects thereof can be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the subject disclosure. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 2.7, 3, 4, 5, 5.3, and 6. This applies regardless of the breadth of the range.
Furthermore, the described features, advantages and characteristics of the exemplary embodiments of the subject disclosure may be combined in any suitable manner in one or more embodiments. One skilled in the relevant art will recognize, in light of the description herein, that the subject disclosure can be practiced without one or more of the specific features or advantages of a particular exemplary embodiment. In other instances, additional features and advantages may be recognized in certain embodiments that may not be present in all exemplary embodiments of the present disclosure.
Referring now to the drawings,
With reference to
Longitudinal axis 136 of the medical retractor 122 extends at an angle α from longitudinal axis 138 of the lateral retractor shaft 120. In this exemplary embodiment, the angle α can range from about 90 degrees to about 110 degrees (e.g. 80, 100, and 110 degrees). Starting, for example, slightly distal to the neck 126, the lateral retractor shaft 120 includes a superior flare 140 that extends in a superior direction at an angle β from longitudinal axis 138, that can range, for example, from about 1 degree to about 35 or 40 degrees (e.g., 2, 5, 7, 10, 12, 17, 20, 22, 25, 27, 30, 38, 42 degrees), extending a distance 135 in the superior direction (
With reference to
Anterior retractor 706 further includes a manual indicia of position 754, which in this embodiment in the form of a segment with increased width, though other configurations can be provided to facilitate manual manipulation and to allow an operator to manually ascertain when he or she is approaching the junction 144. The anterior retractor further includes a second lateral retractor shaft 756 extending, in this exemplary embodiment, at about a right angle from a longitudinal axis 736 defined by the medial retractor shaft 722, though it can alternatively extend at other angles, e.g., 80 and 100 degrees.
In this exemplary embodiment, through holes 162a, 162b extend obliquely at an angle γ, from the longitudinal axis 166 of from about 91 degrees to about 110 degrees (e.g., 92, 94, 96, 98, 100, 102, 104, 106, and 108 degrees) and through hole 162c is cut substantially perpendicular to the longitudinal axis at an angle, Δ that is, for example, from about 85 degrees to about 95 degrees (e.g., 90, 93, 97 degrees). Other dimensioning can be provided in alternative embodiments. Through hole 162c includes a circular flange-like counter sink 168 of increased diameter about an anterior-facing face 170 of the alignment guide shaft 114.
The alignment guide shaft 114 includes a segment 172 of narrower width compared to the distal end extending from the engagement segment 158, and extends to a guide aperture 174 about the distal end 112 of the alignment guide shaft 114. As shown best in
The guide aperture 174 includes through holes 178a, 178b traversing the guide aperture 174 as shown in
With reference to
Thumb turn 192 is best shown in
The guide aperture 174 can be provided with a guide insert 195, as shown in
In one exemplary embodiment, the guide 110 further includes the guide insert 195, that can be welded into the guide aperture 174. Alternatively, the guide insert 195 can be provided as a separate component. The guide insert 195, shown in
With reference to
The guide pin cannula 169 is shown in
A quarter-circular flange 155 is provided about the distal end 157 of the guide pin cannula. The quarter-circular flange 155 includes a truncated face 153. As shown in
The guide pin 102 is configured as best shown in
Operation of the surgical instrument system 100 will now be described in greater detail, based on use of the guide pin cannula disclosed in
The alignment guide aperture 174 slidably houses the guide pin cannula 161, which in turn contains a guide pin advanceable therein. The guide pin cannula is advanced in a longitudinal direction through the guide pin aperture until the ball detent 143 engages either groove 159b or 159c, which should engage the distal end 157 of the cannula with the glenoid cavity 102 at the Bovie™ mark for anatomically conventional subjects. The flange 155 is then made flush with the glenoid cavity.
Alternatively, if a guide pin insert 195 is employed instead of guide pin cannula 161, the guide pin 102 can be advanced in a longitudinal direction through aperture 183 to penetrate the glenoid cavity at the Bovie™ mark.)
After the flange 155 is made flush with the glenoid cavity, the guide pin is advanced through the internal bore 167 of the guide pin cannula 161 (or inner aperture 183 of the guide pin insert 195) to penetrate the glenoid cavity and exit the far medial glenoid vault cortex just posterior to the tip 116 (see
It will be appreciated by those skilled in the art that changes could be made to the exemplary embodiments described above without departing from the broad inventive concept thereof. It is to be understood, therefore, that this disclosure is not limited to the particular embodiments disclosed, but it is intended to cover modifications within the spirit and scope of the subject disclosure as defined by the appended claims.
Kuczynski, John D., Stchur, Robert Patrick
Patent | Priority | Assignee | Title |
Patent | Priority | Assignee | Title |
5437677, | Oct 09 1992 | Smith & Nephew, Inc | Glenoid alignment guide |
7294133, | Jun 03 2004 | ZIMMER, INC | Method and apparatus for preparing a glenoid surface |
Executed on | Assignor | Assignee | Conveyance | Frame | Reel | Doc |
Nov 13 2020 | Sure Orthopedics LLC | (assignment on the face of the patent) | / | |||
Nov 20 2020 | STCHUR, ROBERT PATRICK | Sure Orthopedics LLC | ASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS | 054492 | /0237 | |
Nov 24 2020 | KUCZYNSKI, JOHN D | Sure Orthopedics LLC | ASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS | 054492 | /0237 |
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